Adults Paeds

IV Midazolam IV Midazolam
1 ampoule = 5 mg / ml 0.1 mg/kg
½ dose = 2.5 mg / ml
Antidote: Flumazenil IV Pethidine
IV Pethidine 1 mg/kg
1 ampoule = 50 mg / ml
½ dose = 25 mg / ml 20 kg = 1 cc
Antidote: Naloxone 30 kg = 1.5cc
40 kg = 2cc
1cc + 4cc (water of injection) = 5cc 50 kg = 2.5cc
Half dose = 2.5 cc max 2.5 cc in 2 minutes

SpO2 monitoring
Put on NPO2
Reversal agent

Commonly Used Drugs for Procedural Sedation and Analgesia in Adults

Drug Adult Dose Onset of Duration of Common adverse

Action Action effects
Midazolam 0.02 – 0.1 mg/kg IV 1 – 2 min 30 – 60 min 1. Respiratory
initially ; if further depression
sedation is required , may 2. Hypotension
repeat with 25% of initial
dose after 3 – 5 min , not Reversal agent :
to exceed 2.5 mg/dose Flumazenil
Fentanyl 1 – 2 mcg/kg slow IV push 1 – 2 min 30 – 60 min 1. Respiratory
(over 1 – 2 min) ; may depression
repeat dose after 30 min 2. Hypotension
3. Dysphoria
4. Nausea and
vomiting
Pethidine 50 – 150 mg PO / IM / SC < 1 min 2 – 4 hours 1. Respiratory
q3 – 4 hr PRN ; adjust depression
dose based on degree of
response Reversal agent :
Naloxone
Propofol 0.5 – 1 mg/kg IV loading < 1 min 3 – 10 min 1. Rapidly causes
dose; may repeat by 0.5 deepening
mg/kg increments q3- sedation
5min 2. Cardiovascular
depression
3. Hypotension